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Uptake and effectiv...
Uptake and effectiveness of newer biologic and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis: results from five Nordic biologics registries
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- Glintborg, B. (author)
- Copenhagen University Hospital,University of Copenhagen
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- Di Giuseppe, D. (author)
- Karolinska Institutet
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- Wallman, Johan Karlsson (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Skåne University Hospital
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- Nordstrom, D. C. (author)
- University of Helsinki
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- Gudbjornsson, B. (author)
- National University Hospital of Iceland
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- Hetland, M. L. (author)
- Copenhagen University Hospital,University of Copenhagen
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- Askling, J. (author)
- Karolinska Institutet
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- Grondal, G. (author)
- National University Hospital of Iceland
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- Sokka, T. (author)
- Jyväskylä Central Hospital,University of Eastern Finland
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- Provan, S. A. (author)
- Diakonhjemmet Hospital
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- Michelsen, B. (author)
- Diakonhjemmet Hospital,Sørlandet Hospital
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- Kristianslund, E. K. (author)
- Diakonhjemmet Hospital
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- Dreyer, L. (author)
- Aalborg University Hospital,Aalborg University
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- Love, T. J. (author)
- University of Iceland
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- Lindström, Ulf (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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(creator_code:org_t)
- 2023-02-22
- 2023
- English.
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 82:6, s. 820-828
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Abstract
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- BackgroundWe aimed to describe the uptake of newer biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in psoriatic arthritis (PsA) in the Nordic countries and to compare their retention and effectiveness. MethodsPatients with PsA starting a b/tsDMARD in 2012-2020 in five Nordic rheumatology registers were included. Uptake and patient characteristics were described, with comorbidities identified from linkages to national patient registries. One-year retention and 6-month effectiveness (proportions achieving low disease activity (LDA) on the Disease Activity Index for PSoriatic Arthritis based on 28-joint evaluation) for the newer b/tsDMARDs (abatacept/apremilast/ixekizumab/secukinumab/tofacitinib/ustekinumab) were compared with adalimumab through adjusted regression models stratified by treatment course (first, second/third, and fourth or more). ResultsIn total, 5659 treatment courses with adalimumab (56% biologic-naive) and 4767 courses with a newer b/tsDMARD (21% biologic-naive) were included. The uptake of newer b/tsDMARDs increased from 2014 and plateaued in 2018. Patient characteristics appeared similar across treatments at treatment start. Adalimumab was more often used as the first course and newer b/tsDMARDs more often in biologic-experienced patients. Used as a second/third b/tsDMARD, the retention rate and the proportion achieving LDA were significantly better for adalimumab (rate 65%, proportion 59%) compared with abatacept (45%, 37%), apremilast (43%, 35%), ixekizumab (LDA only, 40%) and ustekinumab (LDA only, 40%), but not significantly different from other b/tsDMARDs. ConclusionUptake of newer b/tsDMARDs occurred mainly in biologic-experienced patients. Regardless of mode of action, only a minority of patients starting a second or later b/tsDMARD course remained on drug and achieved LDA. Superior outcomes for adalimumab indicate that the positioning of newer b/tsDMARDs in the PsA treatment algorithm remains to be established.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- biological therapy
- epidemiology
- spondylitis
- ankylosing
- tumor necrosis factor inhibitors
- spondylitis, ankylosing
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Glintborg, B.
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Di Giuseppe, D.
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Wallman, Johan K ...
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Nordstrom, D. C.
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Gudbjornsson, B.
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Hetland, M. L.
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show more...
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Askling, J.
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Grondal, G.
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Sokka, T.
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Provan, S. A.
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Michelsen, B.
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Kristianslund, E ...
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Dreyer, L.
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Love, T. J.
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Lindström, Ulf
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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Annals of the Rh ...
- By the university
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University of Gothenburg
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Lund University
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Karolinska Institutet